| NPI | 1427787167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT021283) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: IL 070-026981) | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2024-08-02 |